Provider Demographics
NPI:1578388427
Name:KEITA, DAOUDA HUSMEIN
Entity type:Individual
Prefix:
First Name:DAOUDA
Middle Name:HUSMEIN
Last Name:KEITA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1330 TARA PIPER LN
Mailing Address - Street 2:
Mailing Address - City:BLACKLICK
Mailing Address - State:OH
Mailing Address - Zip Code:43004-7539
Mailing Address - Country:US
Mailing Address - Phone:614-717-8186
Mailing Address - Fax:
Practice Address - Street 1:1330 TARA PIPER LN
Practice Address - Street 2:
Practice Address - City:BLACKLICK
Practice Address - State:OH
Practice Address - Zip Code:43004-7539
Practice Address - Country:US
Practice Address - Phone:614-717-8186
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-16
Last Update Date:2024-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes372600000XNursing Service Related ProvidersAdult CompanionGroup - Single Specialty